| NPI | 1265841274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104266) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9104266) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2015-06-04 |